CASE STUDY PFIZER

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PFIZER IN NIGERIA (abridged)*

Recent decades have witnessed true globalization of business, as offshoring and outsourcing

have uprooted many traditionally local processes. Companies in the apparel industry, for example, have

sourcing partners around the world. Similarly, call centers that serve people in the United States are

often located in Latin America, India and the Philippines. The pharmaceutical industry has also taken

advantage of opportunities that result from increasing globalization. In conducting trials overseas,

pharmaceutical companies are able to achieve significant financial benefits by expediting the process of

getting drugs to market. Pharmaceutical companies are nevertheless careful in selecting venues for trials

in other countries, for it is important that the results can be used in securing drug approval in the United

States.

In the 1990s, Pfizer (a pharmaceutical drug company) is greeted by an unusual opportunity.

Researchers at Pfizer are currently developing a drug, Trovan, which seems to hold tremendous

potential in treating a variety of ailments. Trovan is currently in a later stage of the trial process.

Meningitis is one of the diseases believed to be treatable by Trovan, and there is currently a meningitis

epidemic in Kano, Nigeria.

As Pfizer considers the situation, there are a number of attractive features. First, the

government of Nigeria seems supportive of a trial being conducted in Nigeria. Medical resources are

limited throughout the country, particularly in remote areas such as Kano; this would provide some

treatment for people who otherwise likely would not have access to any sort of treatment.

In addition, the people in Nigeria—especially in Kano—are particularly good candidates for a

trial in that they are considered “naïve.” A naïve population is one affected by few, if any, other

substances. The people in Kano have predictable dietary patterns and do not take other types of

medication. Anyone administering a drug trial has to be wary of candidates who take foreign substances

(such as medications) because of the possible interaction between the trial drug and anything else.

An added benefit of conducting the trial in Nigeria is that children can be tested. It is not

possible to test children in the United States, but the results of trials including children outside the

United States can be used in getting a drug approved in the United States.

As much as people in Kano could benefit from a Trovan trial, drug trials generally require

consent. Illiteracy is extremely high in Nigeria—particularly in Kano—most local people are unfamiliar

with all that a “drug trial” entails. A trial is temporary; once the trial ends, drugs are no longer provided

*This case is based on a real situation. Some of the names and events have been disguised or modified for the purpose of illustration for the intended class discussion. Copyright © 2012 by Neu Academic Press. To order copies or request permission to reproduce materials please go to http://www.study.net. No part of this publication may be reproduced, stored in a retrieval system, used in a spreadsheet or transmitted in any form or by any means—electronic, mechanical, photocopying, recording or otherwise—without the permission of Neu Academic Press.

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to the participants. In addition, not everyone who participates in a trial gets the drug—some receive

placebos (or the equivalent). And there could be side effects. The very nature of the trial process, even

during its later stages, is to ferret out possible side effects. Identifying these side effects typically means

that participants exhibit them. If the people of Kano develop side effects, however unlikely, they do not

have easy access to medical facilities that will provide them with long-term treatment options.

If Pfizer is to act, the company needs to act quickly and with certainty. The bacterial form of

meningitis that is currently affecting the people in Kano has a 40% fatality rate, and it frequently attacks

young children. Because the symptoms are not easily detected, children under 12 who contract

meningitis usually die from the disease unless they receive immediate medical attention. Trovan holds

tremendous potential as a cure.

You are hired by Pfizer as consultant. How do you advise Pfizer to respond to the possibility of

conducting a drug trial in Nigeria in response to the current meningitis epidemic in Kano?